Individual
AUDREY HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9855 EDGELAKE DR, LA MESA, CA 91941-4427
(801) 376-8643
Mailing address
9855 EDGELAKE DR, LA MESA, CA 91941-4427
(801) 376-8643
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
05/09/2024
Last updated
05/09/2024
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